Method for the registration and evaluation of dental findings as well as an apparatus for the implementation of the method

ABSTRACT

A method for the registration and evaluation of dental findings corresponding to dental examination points. The method is carried out with an evaluation apparatus including a marking apparatus having spatial allocations corresponding to each examination point and a marking element associated with each spatial allocation. The method comprises the steps of examining the points, one after the other, in a predetermined order to obtain respective dental findings; entering the finding corresponding to each examination point into the evaluation apparatus; and marking the finding of each examination point in the corresponding spatial allocation on the marking apparatus by use of the associated marking element.

BACKGROUND OF THE INVENTION

The invention relates to a method for the registration and evaluation ofdental findings as well as to an apparatus for the implementation of themethod.

In order to control the mouth hygiene during a systematic periodontaltreatment a repeated exact registration of dental findings of possiblyexisting dental film (plaque) is absolutely essential. To achieve this,a visual determination and a manually drawn-up registration of theplaque findings, as practised up to now, no longer satisfy therequirements for a consistent periodontal treatment moreover, thediagnosis practised so far is comparatively inefficient andtime-consuming, and a possible record of the findings does not comprisethe desirable informative effect, especially not for the patient, andoffers only little motivating incentive for further dental care.

SUMMARY OF THE INVENTION

It is an object of the present invention to provide a method that, onthe one hand, can be implemented with little expense in time andpersonnel and that is, on the other hand, suited to better explain thefindings to the patient and motivate him at the same time to carry outan effective dental care.

These and other objects are accomplished in accordance with theinvention in which a method is provided for the registration andevaluation of dental findings corresponding to dental examinationpoints. The method is carried out with an evaluation apparatus includinga marking apparatus having spatial allocations corresponding to eachexamination point and a marking element associated with each spatialallocation. The method includes the steps of examining the points, oneafter the other, in a predetermined order to obtain respective dentalfindings; entering the finding corresponding to each examination pointinto the evaluation apparatus; and marking the finding of eachexamination point in the corresponding spatial allocation on the markingapparatus by use of the marking element.

The method proposed allows for the implementation of recordingexamination findings with lower expenditure in personnel and time andoffers, above all, the possibility to illustrate in an impressive mannerthe record of the findings to the patient. The optical markings may beachieved either by electric lamps, one of which is allocated to eachexamination point and is lit up when the finding is positive and/or by agraphic representation.

It is advantageous to give the ratio of the number of the positivefindings to the number of examination positions and to let the quotientthus reached appear on a display tableau as a so-called index (e.g.plaque index) in terms of percentage. The dentist, as well as thepatient, are thereby in a position to observe the success of aperiodontal treatment by means of the index.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a schematic view of an apparatus for implementing the methodaccording to the invention.

FIG. 2 is a registration carrier for the apparatus of FIG. 1.

FIG. 3 is a circuit diagram for power supply for the apparatus of FIG.1.

FIG. 4 is a circuit diagram for switching amplifier for the apparatus ofFIG. 1.

FIG. 5 is a circuit diagram for a pulse generator for the apparatus ofFIG. 1.

FIGS. 6A and 6B illustrate a circuit schematic of a counter unittogether with controlling amplifiers for the apparatus of FIG. 1.

FIG. 7 shows a schematic view of a display tableau according to animproved version of the invention.

FIG. 8 illustrates a sensor head according to a further aspect of theinvention.

FIG. 9 is a circuit diagram for an AF amplifier for a sensor headaccording to FIG. 8.

FIG. 10 is a circuit diagram for a display driver for a tableauaccording to FIG. 7.

FIG. 11 is a circuit diagram for a further embodiment of a displaydriver.

FIG. 12 is a block diagram for an improvement of the invention with astorage means and a printer.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

The arrangement shown in FIG. 1 consists of a registration apparatus 10as well as a double foot switch 20 and a calculator 17, both connectedto the apparatus 10. The registration apparatus 10 has a registrationfield 13 on its upper side comprising a plurality of heating elements15. A registration carrier 30 (FIG. 2) can be placed onto thisregistration field and pressed down by a folding lid 14. Theregistration carrier consists of thermo-sensitive paper on which hasbeen printed a dentition diagram of known arrangement. The position ofthe teeth of the four quadrants are labelled with numbers 1 to 8. Theregistration apparatus 10 further includes a field of LEDs (lightemitting diodes) 11.

The method as well as the apparatus according to the invention will nowbe described in connection with FIGS. 1 and 2. A registration carrier 30is placed onto the registration field 13 and held in place by foldingdown lid 14. After actuation of power switch 12, the apparatus is in itsstarting position and a counter in the registration apparatus is also inits starting position. Now the patient's teeth are examined in a definedorder for plaque in the interdental spaces. If the finding is positive,the positive switch 21 of foot switch 20 is actuated; if the finding isnegative, the negative switch 22 is actuated. Actuation of one or theother of these two switches, 21 or 22, advances the counter into itsfirst position, lighting the first light emitting diode 11. Operation ofthe positive switch causes a simultaneous actuation of the first of theheating elements 15 and produces thereby a mark 32 between teeth 8 and 7in the upper left quadrant.

Each actuation of one or the other of switches 21 or 22 advances thecounter by one position, and the corresponding LED indicates thecorresponding serial position of the examination. If the positive switchis actuated the appropriate heating element 15 is energized and a markprinted at the corresponding mark position; if the negative switch isactuated no mark is printed at the corresponding marking position. Thisprocedure is continued until the last marking position has been reached.The registration carrier 30 now clearly indicates at what positionsplaque is existing, and this print-out may be compared with prints offurther examinations. Moreover, the plaque index can be obtained bydividing the number of positive findings by the number of examinationpoints.

Parallel to the marking of the registration carrier 30 at each positivefinding, a counting pulse is fed through line 16 to the calculator 17,the display 18 of which will after termination of the examinationindicate the number of positive findings. Subsequently this result isdivided by the number of examination steps entered via keyboard 19, andthe plaque index is obtained when the result of the division is given interms of percentage.

In the following text the functioning of the circuit arrangementaccording to FIGS. 3 to 6 will be described. Please note that lines andterminals in the various Figures marked with identical numerals orletters are connected to each other.

The power supply in FIG. 3 provides +9 volts dc at terminal 106, and +24volts dc at terminal 107, both voltages being with respect to groundterminal 105. Terminals 103, 104 provide 3 volts ac for the heatingelements 15.

FIG. 4 shows a switching amplifier, thirty of which are provided fordriving the thirty heating elements 15. Inputs 110 of each switchingamplifier is connected to the corresponding output 110 of the counter(FIG. 6). Depending on the state of the counter, one of the switchingamplifiers receives an impulse via its terminal 110, which impulse firesthyristor 53 via transistors 51 and 52 if it is not short-circuited bytransistor 50. The time-constant of capacitor 57 and resistor 58 is sodimensioned that thyristor 53 will be conductive for a period of 2.5seconds.

FIG. 5 shows an arrangement of two pulse generators for deriving definedcontrol pulses (contact bounce suppression) for the counter (FIG. 6)from the actuation of the positive switch 21 (contact 111) or thenegative switch 22 (contact 112), respectively. Each pulse generatorcomprises two transistors 60,61 or 62,63 that are connected in monoflopfashion to provide an output pulse of 0.5 seconds duration at thecollector of transistor 60 or 62, if triggered by the closing of thecorresponding switch 111 or 112. These pulses flow via a couplingcapacitor to terminal 101 leading to the counter (FIG. 6).

If the positive switch (contact 111) is actuated a counting pulse flowsvia terminal 101 to the counter. Simultaneously a signal flows from theappropriate counter output to the corresponding switching amplifier(input 110) so that thyristor 53 energizes the corresponding heatingelement for 2.5 seconds. If the negative switch (contact 112) isactuated a counting pulse is also fed via terminal 101 to the counter.At the same time, however, transistors 68 and 50 (FIG. 4) becomeconductive, whereby the signal at terminal 110 of the switchingamplifier (FIG. 4) is short-circuited and the corresponding thyristor 53will not become conductive. The switching amplifier and the heatingelement 15 corresponding to this counter state will thus not beenergized.

The counter shown in FIG. 6 comprises eight integrated counter circuitsIC1 to IC8. The integrated circuit IC1 is of the type Telefunken SAS 660and the others are of the type Telefunken SAS 670. The circuit IC1 (SAS660) is of such configuration that upon switching on the supply voltagethe whole counter is set into its starting position in which none of thethirty LEDs 11 connected to the outputs is energized. In this positionnone of the thirty outputs 110 provide a signal. Each counting pulse fedto terminal 101 (actuation of positive switch 111 or negative switch112) advances the counter by one position so that the corresponding LEDs11 will be energized one after the other.

The whole arrangement functions as follows: The counter (FIG. 6) is inits starting position when the apparatus is switched on. Each actuationof a switch 21 (contact 111) or 22 (contact 112) advances the counterinto the following position, whereby the thirty switching amplifiers(FIG. 4) will receive signals one after the other and the respectiveworking states will be indicated by the corresponding LED 11. If thepositive switch was actuated the corresponding heating element 15 isenergized at the same time and prints a mark 32 on registration carrier30. If the negative switch was actuated the signals at inputs 110 of theswitching amplifiers are short-circuited by transistor 50 so that theheating element 15 corresponding to the respective counting position isnot energized.

Terminal 120 shown in FIG. 5 is provided to deliver counting pulses tocalculator 17 (FIG. 1). At each actuation of the positive switch 21(contact 111) a pulse is delivered from the collector of transistor 60to the calculator so that at the conclusion of the operation thecalculator will have added up the number of positive findings.

FIG. 7 shows a schematic view of a display tableau 200 that can beconnected to the basic apparatus shown in FIGS. 3 to 6. Thirty lamps 201are placed at the interdental positions of a dentition diagrampreferably arranged in the form of a broad and laughing mouth in a facethat is well-known to children. The lamps will be switched onsimultaneously when the corresponding heating elements 15 are energized.

FIG. 10 shows a switching circuit as provided for each such lamp. Input211 is connected to the switching amplifier (FIG. 4, dotted connection211) and triggers a thyristor 204 if an appropriate signal is present atcapacitor 57 (FIG. 4). The lamp 205 will be lit and this state will bestored until the supply voltage of thyristor 204 is interrupted by areset switch 207. On completion of a full examination procedure thelighting up of the energized lamps (film existing on tooth) willdemonstrate impressively to the patient the state of his dental hygiene.

FIG. 11 shows an an alternative embodiment for of the switching circuitof FIG. 10 in which the examination result of a preceding examinationcan be overwritten by the results of a new examination. The results ofthe preceding examination can be stored in a store by means of a codecard and read into the apparatus according to the invention fordemonstration to the patient before the subsequent examination is begun.Lamps going out or new ones lighting up make it possible to visuallyobserve an improvement or a deterioration of the new findings.

The function of the switching circuit of FIG. 11 is as follows:Controlled from a storage means all thyristors 204 conductive during thefirst examination are fired again, so that the first findings are shownon the display tableau. In order to enable the erasure of the state ofall thyristors after each new finding, the supply line is connected viaa transistor 212 which is held normally in conductive state by aresistor 227. An erase pulse (of approximate 0.2 seconds duration) isfed via capacitor 202 to transistor 212 from terminal 210 (dotted linein (FIG. 4) when the counter (FIG. 6) reaches the position allocated tothe corresponding switching amplifier. In the case of a positive findinga firing pulse of longer duration than the erase pulse is fed to input211 so that the thyristor again energizes the corresponding lamp 205. Inthe case of negative finding, no signal appears at input 211 so thatthyristor 204 is not fired again. The capacitor 203 serves to suppressinterference pulses of short duration.

FIG. 8 shows a sensor head 220 having two sensor surfaces 221 and 222.In the case of a positive finding the gum of the patient is touched withthe sensor surface 221 below the corresponding interdental space; in thecase of a negative finding the sensor surface 222 is touched by thefinger of the examining person. Each of these two sensor surfaces 221and 222 is connected to input 225 of an AF amplifier (FIG. 9) that isbiased into a linear working region by a series resistor 224. When input225 is touched, a hum voltage is developed at the output 226. Oneamplifier each (FIG. 9) is connected to terminals 108 and 109 of thepulse generator (dotted lines 208 and 209 in FIG. 5) instead of theinput switches 111 and 112, which amplifiers trigger the correspondingmonoflop when a sensor surface is touched. The preamplifiers (FIG. 9)can be integrated in the sensor head.

The block diagram of FIG. 12 shows a further version of the presentinvention. A control unit 300, together with a printer 373, performsimilar tasks as the registration apparatus 10 of FIG. 1. The controlunit contains also a field of LEDs 377 to indicate the variousexamination positions. Instead of the registration field 13 and theheating elements 15, a printer 373 is provided that is controlled via acable 362 from the control unit in such a way that it prints thefindings for the individual dentition positions in spatialcorrespondence onto a dentition diagram provided on an output paper 378.

The control unit can similarly control a display tableau (as seen inFIG. 7) to give, parallel to the printout, a visual demonstration of thefindings.

Via leads 301 to 330 there is connected to the control unit 300 a storemeans 374 by which the various findings can be stored in well-knownmanner on a magnetic card 375. To do this the mode selector 376 isswitched to "WRITE". The magnetic or coding card can be kept in apatient's file and is available for subsequent examination. At suchfollow-up examinations the magnetic card is loaded into the store means374 and the selector 376 switched to "READ". Now the data of thefindings stored on the magnetic card 375 are read out and furnished viathe control unit 300 to the display tableau 370. The previous findingsthus made visible may then be overwritten by the new findings asexplained in connection with FIGS. 7 and 11.

The magnetic card can have a plurality of storage tracks, each of whichcan be used to store the findings of one examination. In this way theresults of several examinations can be selectively read out anddemonstrated on the tableau.

Although the description has so far mainly referred to the ApproximalSpace Plaque Index (API) where all interdental spaces are evaluated forpositive or negative results, it is, of course, also possible to use theinvention for other evaluation methods.

Furthermore it is not absolutely necessary to allocate the examinationresults to the interdental spaces, they may also relate to the differenttooth positions themselves in the dentition diagram.

As printer 373 is equipped to print a great variety of differentcharacters or signs (contrary to the thermal registration apparatus ofFIG. 1 having simple heating elements 15), it is of course also possibleto print signs like "+" or "-" directly at the appropriate spatialpositions of the dentition diagram. It is moreover possible to print notonly two different examination results like "positive" or "negative",but practically any number of different findings. To establish a plaqueindex according to the Quigley-Hein method, for example, it is necessaryto give the individual tooth a grade. In addition to the finding "0",five additional result grades have to be represented; this can easily beachieved with a printer 373 by printing the figures 0 to 5. It isevident that in this way any number of graded examination results can berepresented.

For the determination of the plaque index according to Silness-Loe notall interdental spaces are graded, but four surfaces of selected teethat a time, and the spatial representation of the dentition diagram inthe registration apparatus must be adapted accordingly.

We claim:
 1. An apparatus for recording and evaluating a number ofdental findings each corresponding to a respective one of a given numberof dental examination positions, said apparatus comprising:a markingcarrier imprinted with a dental scheme indicating the location of eachexamination position; a marking device including a number of markingelements each arranged to correspond to a respective one of theexamination positions for marking said marking carrier; an input devicefor producing two different switching instructions each corresponding toa different dental finding; a counter connected to receive the twodifferent switching instructions from said input device, said counterhaving a plurality of counter outputs each corresponding to a respectiveone of the examination positions and said counter being operative toswitch over an enabling signal from one said counter outputcorresponding to one examination position to a next counter outputcorresponding to the next examination position in the dental scheme uponreceipt by said counter of either of said two different switchinginstructions; a plurality of switching amplifiers each connecting arespective one of said counter outputs to a respective one of saidmarking elements corresponding to the same examination position as saidrespective counter output, wherein the switch over of the enablingsignal to said next counter output enables the switching amplifiercorresponding to the examination position associated with said nextcounter output, and each said switching amplifier includes excitingmeans responsive to said input device for causing that switchingamplifier, when enabled by said counter, to excite the correspondingmarking element unless a given one of said two different switchinginstructions is produced by said input device.
 2. An apparatus asdefined in claim 1, wherein said marking carrier is heat sensitivepaper, said marking elements are heated elements spatially arranged tocorrespond to the location of the examination positions indicated by thedental scheme imprinted on said heat sensitive paper, said markingdevice is constructed to mount said heat sensitive paper above saidheating elements, and the enabled switching amplifier excites theheating element associated with said enabled switching amplifier for ashort time when said given one of the two different switchinginstructions is produced by said input device.
 3. An apparatus asdefined in claim 1, and further comprising a display device having anumber of display elements corresponding to the given number ofexamination positions, said display elements being spatially arrangedaccording to the location of examination positions indicated by thedental scheme and said display device being connected to said counter sothat said display elements are actuated in succession with everyswitching instruction to display the respective examination positions.4. An apparatus as defined in claim 3, wherein said display elements arelamps.
 5. An apparatus as defined in claim 4, wherein said lamps arelight emitting diodes.
 6. An apparatus as defined in claim 1, whereinsaid input device is a foot switch including two switching contacts forfurnishing the two different switching instructions.
 7. An apparatus asdefined in claim 1, and further comprising a calculating means includinga display and connected for receiving and making a first count of allswitching instructions and and making a second count of only the givenone of said two different switching instructions, said calculating meansincluding means for forming a quotient of said first and second countsand displaying said quotient on said display.
 8. An apparatus as definedin claim 7, wherein said input device includes a pulse generator forproducing a pulse corresponding to the given one of said two differentswitching instructions, and said calculator comprises a pocketcalculator having a percent key and which adds the pulses correspondingto the given one of said two different switching instructions.
 9. Anapparatus as defined in claim 1, and further comprising a displaytableau having a carrier panel with display lamps arranged on saidcarrier panel to correspond with the location of the examinationpositions indicated by the dental scheme imprinted on said markingcarrier, said lamps each being connected to be switched on incorrespondence to the given one of said two different switchinginstructions.
 10. An apparatus as defined in claim 9, wherein saiddisplay lamps are arranged to be uniformly spaced from each other onsaid carrier panel and to delineate an overdimensionally drawn dentalscheme.
 11. An apparatus as defined in claim 9, and further comprising alamp circuit associated with each display lamp; display drivers eachcoupled to a respective one of said display lamp circuits and to arespective one of said switching amplifiers, said display drivers eachhaving memory means for maintaining energization of said display lampsafter termination of the enabling signal; and a common interruptingswitch connected in series with all said lamp circuits for disconnectingsaid display lamps.
 12. An apparatus as defined in claim 11, and furthercomprising interrupting transistors each connected in a respective oneof said lamp circuits for blocking said lamp circuit for a shortduration if a new dental finding is to be displayed.
 13. An apparatus asdefined in claim 1 wherein said input device comprises a finger operatedswitch having two switch contacts each for producing a respective one ofsaid two different switching instructions.
 14. An apparatus as definedin claim 13, wherein said finger operated switch comprises a sensor penhaving a sensor tip for producing a first switching pulse correspondingto one of said two different switching instructions and a sensor platedisposed on the circumference of said sensor pen for producing a secondswitching pulse corresponding to the other of said two differentswitching instructions.
 15. An apparatus as defined in claim 14, whereinsaid sensor pen includes first and second low frequency amplifiers eachhaving an output and each connected to receive an input from arespective one of said sensor tip and said sensor plate, said first lowfrequency amplifier delivering a switching pulse to its output when saidsensor tip is touched, and said second low frequency amplifierdelivering a switching pulse to its output when said sensor plate istouched.